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Emergence of Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli Isolates possessing the plasmid-mediated carbapenem-hydrolyzing beta-lactamase KPC-2 in intensive care units of a Chinese hospital.
Antimicrob Agents Chemother. 2008 Jun; 52(6):2014-8.AA

Abstract

Twenty-one Serratia marcescens, ten Klebsiella pneumoniae, and one Escherichia coli isolate with carbapenem resistance or reduced carbapenem susceptibility were recovered from intensive care units (ICUs) in our hospital. Enterobacterial repetitive intergenic consensus-PCR and pulsed-field gel electrophoresis demonstrated that all the S. marcescens isolates belonged to a clonal strain and the 10 K. pneumoniae isolates were indistinguishable or closely related to each other. The MICs of imipenem, meropenem, and ertapenem for all isolates were 2 to 8 microg/ml, except for K. pneumoniae K10 (MICs of 128, 256, and >256 microg/ml). Isoelectric focusing, PCRs, and DNA sequencing indicated that all S. marcescens isolates produced KPC-2 and a beta-lactamase with a pI of 6.5. All K. pneumoniae isolates produced TEM-1, KPC-2, CTX-M-14, and a beta-lactamase with a pI of 7.3. The E. coli E1 isolate produced KPC-2, CTX-M-15, and a beta-lactamase with a pI of 7.3. Conjugation studies with E. coli (EC600) resulted in the transfer of reduced carbapenem susceptibility compared to that of the original isolates, and only the bla(KPC-2) gene was detected in E. coli transconjugants. Plasmid restriction analysis showed identical restriction patterns among all E. coli transconjugants. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and ompK35/36 gene sequence analysis of outer membrane proteins revealed that K. pneumoniae K10 failed to express OmpK36, because of insertional inactivation by an insertion sequence ISEcp1. All these results indicate that KPC-2-producing S. marcescens, K. pneumoniae, and E. coli isolates emerged in ICUs in our hospital. KPC-2 combined with porin deficiency results in high-level carbapenem resistance in K. pneumoniae. The same bla(KPC-2)-encoding plasmid was spread among the three different genera.

Authors+Show Affiliations

2nd Affiliated Hospital of Zhejiang University, 88 Jiefang Rd., Hangzhou, China 310009.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18332176

Citation

Cai, Jia Chang, et al. "Emergence of Serratia Marcescens, Klebsiella Pneumoniae, and Escherichia Coli Isolates Possessing the Plasmid-mediated Carbapenem-hydrolyzing Beta-lactamase KPC-2 in Intensive Care Units of a Chinese Hospital." Antimicrobial Agents and Chemotherapy, vol. 52, no. 6, 2008, pp. 2014-8.
Cai JC, Zhou HW, Zhang R, et al. Emergence of Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli Isolates possessing the plasmid-mediated carbapenem-hydrolyzing beta-lactamase KPC-2 in intensive care units of a Chinese hospital. Antimicrob Agents Chemother. 2008;52(6):2014-8.
Cai, J. C., Zhou, H. W., Zhang, R., & Chen, G. X. (2008). Emergence of Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli Isolates possessing the plasmid-mediated carbapenem-hydrolyzing beta-lactamase KPC-2 in intensive care units of a Chinese hospital. Antimicrobial Agents and Chemotherapy, 52(6), 2014-8. https://doi.org/10.1128/AAC.01539-07
Cai JC, et al. Emergence of Serratia Marcescens, Klebsiella Pneumoniae, and Escherichia Coli Isolates Possessing the Plasmid-mediated Carbapenem-hydrolyzing Beta-lactamase KPC-2 in Intensive Care Units of a Chinese Hospital. Antimicrob Agents Chemother. 2008;52(6):2014-8. PubMed PMID: 18332176.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergence of Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli Isolates possessing the plasmid-mediated carbapenem-hydrolyzing beta-lactamase KPC-2 in intensive care units of a Chinese hospital. AU - Cai,Jia Chang, AU - Zhou,Hong Wei, AU - Zhang,Rong, AU - Chen,Gong-Xiang, Y1 - 2008/03/10/ PY - 2008/3/12/pubmed PY - 2008/7/17/medline PY - 2008/3/12/entrez SP - 2014 EP - 8 JF - Antimicrobial agents and chemotherapy JO - Antimicrob Agents Chemother VL - 52 IS - 6 N2 - Twenty-one Serratia marcescens, ten Klebsiella pneumoniae, and one Escherichia coli isolate with carbapenem resistance or reduced carbapenem susceptibility were recovered from intensive care units (ICUs) in our hospital. Enterobacterial repetitive intergenic consensus-PCR and pulsed-field gel electrophoresis demonstrated that all the S. marcescens isolates belonged to a clonal strain and the 10 K. pneumoniae isolates were indistinguishable or closely related to each other. The MICs of imipenem, meropenem, and ertapenem for all isolates were 2 to 8 microg/ml, except for K. pneumoniae K10 (MICs of 128, 256, and >256 microg/ml). Isoelectric focusing, PCRs, and DNA sequencing indicated that all S. marcescens isolates produced KPC-2 and a beta-lactamase with a pI of 6.5. All K. pneumoniae isolates produced TEM-1, KPC-2, CTX-M-14, and a beta-lactamase with a pI of 7.3. The E. coli E1 isolate produced KPC-2, CTX-M-15, and a beta-lactamase with a pI of 7.3. Conjugation studies with E. coli (EC600) resulted in the transfer of reduced carbapenem susceptibility compared to that of the original isolates, and only the bla(KPC-2) gene was detected in E. coli transconjugants. Plasmid restriction analysis showed identical restriction patterns among all E. coli transconjugants. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and ompK35/36 gene sequence analysis of outer membrane proteins revealed that K. pneumoniae K10 failed to express OmpK36, because of insertional inactivation by an insertion sequence ISEcp1. All these results indicate that KPC-2-producing S. marcescens, K. pneumoniae, and E. coli isolates emerged in ICUs in our hospital. KPC-2 combined with porin deficiency results in high-level carbapenem resistance in K. pneumoniae. The same bla(KPC-2)-encoding plasmid was spread among the three different genera. SN - 1098-6596 UR - https://www.unboundmedicine.com/medline/citation/18332176/Emergence_of_Serratia_marcescens_Klebsiella_pneumoniae_and_Escherichia_coli_Isolates_possessing_the_plasmid_mediated_carbapenem_hydrolyzing_beta_lactamase_KPC_2_in_intensive_care_units_of_a_Chinese_hospital_ L2 - http://aac.asm.org/cgi/pmidlookup?view=long&pmid=18332176 DB - PRIME DP - Unbound Medicine ER -